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Feature January 2016 Issue

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Cat Bites: Serious Business

Careful wound management is essential in cat bite cases.

The most common victims of cat bites are women, the elderly and children. Almost all cat bites occur when a cat is trapped, cornered, startled or restrained. 75 percent of cat bites involve the face, hands or arms. (Kids tend to get facial bites.) However, even with estimates ranging from 400,000-750,000 bites per year, cat bites account for only a small fraction of all mammalian bites in the US.

Though many more victims go to emergency rooms with dog bites, and cat bites are generally less destructive and life-threatening than dog bites, cat bites do carry a much higher risk of infection. At highest risk for complications from infected cat bites are immunocompromised persons; persons with diabetes, leukemia or lupus; and persons receiving chemotherapy or chronic steroid therapy.

According to a review by Drs. Jeffery Kravetz and Daniel Federman of the Yale School of Medicine, between 28 and 80 percent of cat bites become infected. Cat bites progress more rapidly than other mammalian bites towards infection; severe infections can occur within as little as four to eight hours.

The cat’s long, narrow teeth inoculate pathogens deep beneath the skin, leaving only small, seemingly minor, puncture wounds at the surface. Bites that bleed freely are less likely to become infected. The cat’s teeth can penetrate not just soft tissue but also joints, bones, tendons and tendon sheaths. Infected bites involving the hands, feet, finger joints or knuckles can be particularly serious. Cat bite injuries that involve the tendon sheaths or surrounding compartments in the hand often require surgery and on rare occasions can cause permanent disability.

Careful wound management is essential in cat bite cases. Control bleeding, then clean the wound with antibacterial soap and warm water. Be vigilant for any signs of infection such as redness or swelling at the bite site, swollen lymph nodes, oozing pus, sudden fatigue, fever or pain. Persons at high risk of complications should always seek immediate medical attention for a cat bite, whether or not signs of infection are present.

While there’s some controversy among doctors about the use of prophylactic antibiotics in cat bite victims, antibiotics are commonly used in the following situations, whether or not signs of infection are present: bites to the hands; puncture bites that involve bones or joints; bites in the genital area; and bites to persons at increased risk for infection.

Then there’s the real nightmare: rabies. When a bite comes from a stray or feral cat (or any cat with an unknown vaccination status), it’s vital to capture the animal for observation and testing. In the U.S., cats are more likely than dogs to be infected with rabies, and the numbers are rising.